Journal of Child Health Care

Journal of Child Health Care http://chc.sagepub.com

Fear, failure, outrage and grief: the dissonance between public outrage and individual action? Debra Jackson and Bernie Carter J Child Health Care 2009; 13; 4 DOI: 10.1177/1367493509102278

The online version of this article can be found at: http://chc.sagepub.com

Published by:

http://www.sagepublications.com

On behalf of:

Association of British Paediatric Nurses

Additional services and information for Journal of Child Health Care can be found at:

Email Alerts: http://chc.sagepub.com/cgi/alerts

Subscriptions: http://chc.sagepub.com/subscriptions

Reprints: http://www.sagepub.com/journalsReprints.nav

Permissions: http://www.sagepub.co.uk/journalsPermissions.nav

Citations http://chc.sagepub.com/cgi/content/refs/13/1/4

Downloaded from http://chc.sagepub.com at University of Western Sydney on November 10, 2009 EDITORIAL JCHC Fear, failure, outrage and grief: Journal of Child Health Care Copyright © 2009 SAGE Publications the dissonance between public Los Angeles, London, New Delhi, Singapore and outrage and individual action? Washington DC Vol 13(1) 4–6 DOI: 10.1177/1367493509102278 DEBRA JACKSON Professor, School of Nursing, University of Western Sydney, Australia

BERNIE CARTER Editor-in-Chief of the Journal of Child Health Care Professor of Children’s Nursing, School of Nursing and Caring Sciences, University of Central Lancashire, UK

Recently the case of Baby P has galvanised public opinion in the United Kingdom. Awareness of the details of the tragic life and death of the toddler has resulted in an outpouring of community outrage and grief. However, the sad case of Baby P is not an isolated event. On the other side of the world, in New Zealand, a similarly dreadful fate befell toddler Nia Glassie. Before them have been other terrible and heart-rending cases of children abused by those who should have loved and cared for them, and failed by systems that should have been able to protect them. Published accounts of the suffering of these children are harrowing and horrific. They are almost too sad to contemplate. The stories of both Baby P and Nia have often been accompanied by a single photograph showing them at a time when it still would (should) have been possible to save them – sweet children with shy and uncertain smiles, their innocence jarring with the awfulness and horror of the accompanying text and the knowledge of what their lives became. A quick search of ‘Facebook’ and other internet sites reveals the number of sites that have been dedicated to the memories of Baby P and Nia. Many of the thousands of people who have joined these sites have left moving personal messages. However, as ‘cases’ of abuse or neglect, Baby P and Nia are not isolated or exceptional – many other children whose faces, names and suffering will never become known to the public, also die from abuse and neglect. The outpouring of grief, anger and outrage triggered by the deaths of these particular two children overshadows the fate of the other children. Maybe public outrage can only respond to an ‘occasional’ death? Could we, would we be as outraged if cases like Baby P and Nia hit national headlines every couple of weeks? Indeed the fact that such cases only occasionally create headlines and capture the public imagination says much about the communities and societies that we live in. It is notoriously difficult to obtain accurate statistics on children whose death could be attributed to abuse and it is difficult to compare the figures that do exist between different countries and across time because so many factors have to be taken into account. Definitions of what constitutes child abuse and/or neglect differ, there is

Downloaded from http://chc.sagepub.com at University of Western Sydney on November 10, 2009 JACKSON & CARTER: FEAR, FAILURE, OUTRAGE AND GRIEF no internationally accepted definition of ‘being in care’ or ‘being known to services’, the age range that constitutes a child, and the legal evidence required to be able to reach a verdict. UNICEF provides an interesting and detailed discussion of such issues (UNICEF 2003). In New South Wales (NSW) (Australia) for example, the relevant Minister recently informed a Parliamentary Standing Committee that reviewable deaths of children known to the Department of Community Services (DoCS) in 2007 numbered 156 (up from 114 in the previous year). The report of a Special Commission of Inquiry into Child Protection Services in NSW provides current information into the number of child deaths in NSW arising from abuse or neglect (Wood 2008). The report tells us that during 2007, the number of children in NSW dying while in care rose from the previous year, from 3% in 2006 to 4% in 2007. Also during 2007, 51 NSW children died of abuse, neglect or in suspicious circumstances. In the UK, the accuracy of child abuse and neglect statistics are subject to dispute, yet even the figures that reflect the best picture are appalling. The National Society for the Prevention of Cruelty to Children (NSPCC) drawing on evidence from the Home Office (2007) states ‘every ten days in England and Wales one child is killed at the hands of their parent’. Triggered by the Baby P case, Christine Gilbert, Her Majesty’s Chief Inspector of Education, Children’s Services and Skills and her team provided ‘oral evidence’ on 10 December 2008 to the House of Commons’ Children, Schools and Families Committee on the work of Ofsted which has responsibility for inspecting and regulat- ing care for children and young people. After detailed questioning Michael Hart (Ofsted’s Director, Children) confirmed the figure that ‘more than three children in this country are killed by abuse every week’ (House of Commons 2008). The shocked response from the Committee to this ‘horrific statistic’ was echoed by the public’s response when it was reported in the national media. The most recently published Serious Case Review provides a detailed analysis of the lives of 161 children (two-thirds of whom died and a third were seriously injured) between 2003–2005 (Brandon et al. 2008). Most of the children from the Serious Case Review in the UK and the Special Commission in NSW remain nameless and faceless to the general public. The deaths of Baby P and Nia are emblematic of the anonymous suffering of the children whose cases do not catch the media’s attention. However, knowing about the suffering endured by Baby P and Nia caused people to struggle to understand how such abuse can be perpe- trated on completely defenceless infants, and how it could be that these children could not be saved, despite all manner of interventions by all manner of health and care workers. Phrases such as ‘slipped through the net’ or the ‘cracks’ of ‘the system’ form part of the rhetoric in these distressing cases. Our sense of loss and distress is compounded when we consider the seemingly ample opportunities there appeared to be for intervention – opportunities to create another ending – a better outcome for these (and other) children. Contemplating these deaths raises numerous questions. Could there have been another ending? What interventions could have changed the outcome? How do members of a child’s extended family cope with such a death? How do they reconcile themselves with their families’ failure to protect one of their own? How can nursing and individual nurses act to help protect vulnerable children? How do we cover the cracks so that no young- sters can fall through them? How do child protection workers reconcile the sense of failure and impotence that must surely follow such outcomes? How do community

Downloaded from http://chc.sagepub.com at University of Western Sydney on November 10, 2009 JOURNAL OF CHILD HEALTH CARE 13(1) services react? How can child protection workers and services respond in such a way as to retain (or regain) public confidence? How can we ensure that young children are protected from such brutality? In the weeks since the Baby P verdict in November 2008, there has been a demand for a change in the way that safeguarding services are organised. A Social Work Taskforce has been established with the ‘objectives of reforming initial social work training; driving improvements in the quality of professional practice; attracting and retaining the brightest and best people to social work; and strengthening the delivery system which supports and challenges professional social workers’ (Balls 2008). Whilst the taskforce may well be needed, the public’s perception of the professionals (social workers, in particular) being to blame has had a massive effect on services. Barrett (2008) reports that ‘the number of children granted a care order in London last month was up by 70 per cent on the total for November last year’; whilst this may protect children it will inevitably place huge strains on the foster care system and may be counter-productive. As in past cases, social workers in particular, have been vilified. Under enormous pressure already to do a job that most of their critics would shy away from, the profession itself now feels it is the subject of a witch hunt (see for example, Petition: Stop the Witch Hunt of Social Workers http://www.socialworkfuture. org/?p=31). The other professions have seemingly escaped the intensity of the critique and are seemingly able to reflect less publically on changes that need to be made. In today’s world, horror stories confront us every day. Yet these particular stories have touched so many people in ways that are deeply personal, visceral and intensely moving. The stories of the ongoing suffering and eventual deaths of two young children from opposite parts of the world are appalling in their horror. The awfulness is such that it repels, and can cause an almost instinctual turning away. But as nurses we cannot turn away. We cannot avert our gaze. Nor can we ignore the fact that there are many children who live in the shadow of violence and abuse. As nurses we have a crucial role to play in child protection, in responding to threats to child safety, and in making our communities safer places for children. As citizens and members of neigh- bourhoods, communities and societies, we also must reflect on the question that Ed Balls (2008) posed – that is, why nobody stepped in to prevent these tragedies from happening?

References Balls, E. (2008) ‘Safeguarding Children and the Tragic Death of Baby P’, http://www. edballs.com/index.jsp?i=3730 Barrett, D. (2008) ‘“Baby P effect”: More Children Now Being Removed from Families by Social Workers’, The Telegraph, 6th December 2008. Brandon, M., Belderson, P., Warren, C., Howe, D., Gardner, R., Dodsworth, J. and Black, J. (2008) ‘Analysing Child Deaths and Serious Injury through Abuse and Neglect: What Can We Learn? A Biennial Analysis of Serious Case Reviews 2003–2005’, Research Report DCSF-RR023 edn, Department for Children, Schools and Families, pp. 1–144. House of Commons (2008) Uncorrected Transcript of oral evidence. To be published as HC 70-i. Minutes of evidence taken before the Children, Schools and Families Committee. Children, Schools and Families. UNICEF (2003) ‘A League Table of Child Maltreatment Deaths in Rich Nations’, Innocenti Report Card, No.5 edn, UNICEF Innocenti Research Centre, Florence, pp. 1–36.

Downloaded from http://chc.sagepub.com at University of Western Sydney on November 10, 2009